Provider Demographics
NPI:1710186408
Name:LEE, DONNA B (NONE)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:B
Last Name:LEE
Suffix:
Gender:F
Credentials:NONE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 IOWA ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6820
Mailing Address - Country:US
Mailing Address - Phone:405-321-7331
Mailing Address - Fax:
Practice Address - Street 1:1206 IOWA ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6820
Practice Address - Country:US
Practice Address - Phone:405-321-7331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKNONEOtherDMHSAS